A small portion of shy teenagers may actually have social phobia, according to a new national study of adolescents.

Social phobia, a persistent, debilitating fear of situations that could involve scrutiny and judgment, is a somewhat controversial diagnosis in children and teens, with critics arguing that the diagnosis turns normal shyness into a medical condition. But the new research finds that teens who meet the criteria for social phobia are also more likely to struggle with depression, anxiety, substance disorders and other problems. That finding suggests that social phobia is a serious condition beyond regular shyness, the researchers report Monday (Oct. 17) in the journal Pediatrics.

To uncover the overlap between shyness and social phobia, the researchers drew from a nationally representative survey of 10,123 American teenagers and 6,483 of their parents. In face-to-face sessions, the teenagers answered questions about their level of shyness, anxiety and prescription medication use. The teens were also evaluated for social phobia.

Parents were more likely to rate their teens as shy than the teens themselves, with 62.4 percent of parents saying their teens were shy while only 46.7 percent of teens described themselves that way. Of the students who called themselves shy, 12.4 percent actually met the criteria to be diagnosed with social phobia. Of the teens described as shy by their parents, 10.6 percent met the criteria for social phobia. [Top 10 Controversial Psychiatric Disorders]

Of teens not identified as shy, about 5 percent met the social phobia criteria.

The results suggest that "social phobia is not simply shyness," the researchers wrote. "In contrast to the high frequency of shyness observed among U.S. adolescents, social phobia affected a minority of youth."

More tellingly, the researchers reported, teenagers who met the criteria for social phobia reported more social struggles and more additional psychological disorders than the teens who were simply shy. Despite these troubles, the socially phobic teens were no more likely than their counterparts to be taking medication.

The implication, the researchers wrote, is that social phobia should be taken seriously in young people.

"Although many adolescents with social phobia demonstrate marked impairment, results suggest that few ever seek or obtain professional help," the researchers wrote. "Persistent claims that dispute the severity of this condition among youth likely will do little to alter their course."

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Stephanie Pappas

Stephanie Pappas is a contributing writer for Live Science. She covers the world of human and animal behavior, as well as paleontology and other science topics. Stephanie has a Bachelor of Arts in psychology from the University of South Carolina and a graduate certificate in science communication from the University of California, Santa Cruz. She has ducked under a glacier in Switzerland and poked hot lava with a stick in Hawaii. Stephanie hails from East Tennessee, the global center for salamander diversity. Follow Stephanie on Google+.